How do you get access to a continuous glucose monitor?
The NICE guideline recommends that children and young people are offered ongoing use of real-time CGM with alarms to young people with type 1 diabetes who have frequent severe hypoglycaemia or impaired awareness of hypoglycaemia associated with adverse consequences (for example, seizures or anxiety) or inability to recognise, or communicate about, symptoms of hypoglycaemia (for example, because of cognitive or neurological disabilities).
In addition, the guideline recommends that ongoing use of real-time CGM should also be considered for other groups:
- Neonates, infants and pre-school children
- Children and young people who undertake high levels of physical activity (for example, sport at a regional, national or international level)
- Children and young people who have comorbidities (for example anorexia nervosa) or who are receiving treatments (for example corticosteroids) that can make blood glucose control difficult.
The guideline also recommends considering occasional use of CGM to help children and young people to improve their glucose control especially for those who continue to have hyperglycaemia despite insulin adjustment and additional support.
The NHS is not legally obliged to provide funding for CGM. However, the guideline makes a strong recommendation for CGM to be used with children who are unable to recognise or communicate about hypo symptoms. This includes very young children who cannot tell you they are having a hypo even if they recognise it.
If you cannot get NHS funding, you may want to consider self funding. You do not need a prescription to use CGM, you can buy a system direct from the company. However you are likely to get most benefit from the system if you get support in using it, so do ask what support the company and your diabetes team can give you.
There are two costs associated with CGM:
- The initial cost – for the hardware such as the receiver and transmitter – varies from around £1,000 to £2,500. If you have a newer Medtronic or Animas Vibe pump you may find CGMS is already integrated or may be available if you pay a supplement (around £200).
- Running costs – The main on-going cost is the disposable sensors, costing around £40 – £60 per sensor, with each sensor lasting a recommended 5 – 7 days. Many users find they can wear their sensors for longer than the recommended number of days.
In some cases you also need adhesive covers to keep the sensors in place or protect them from water. You may also need to buy semi-disposable components such as transmitters every 9-18 months or so.
Some of the information above was kindly provided by INPUT, a patient-run group for people using or wishing to use insulin pumps to control their diabetes. Visit inputdiabetes.org.uk for more information.